地佐辛应用于瑞芬太尼静脉麻醉术后痛觉过敏观察

目的观察地佐辛对瑞芬太尼所致术后痛觉过敏的影响。方法上腹部择期手术患者80例,ASAⅠ～Ⅱ级,随机分为四组,均采用静脉复合麻醉加气管插管,术中靶控输注瑞芬太尼,持续静脉注射异丙酚,间断给予维库溴铵维持麻醉。关腹前30min分别肌肉注射地佐辛0.1mg/kg（A组,n=20）、0.2mg/kg（B组,n=20）、0.3mg/kg（C组,n=20）,对照组给予芬太尼1ug/kg（D组,n=20）。记录各组苏醒时间、拔管时间、拔管时患者的血流动力学指标、拔管后的VAS评分、Ramsay评分及要求镇痛距离拔管的时间、拔管后苏醒室内患者恶心呕吐及烦躁等不良反应。结果拔管时的血流动力学指标四组比较无统计学意义（p〉0.05）;苏醒时间及拔管时间D组最长,恶心呕吐发生率D组最高,苏醒后VAS评分A组最高,B组和C组次之（p〈0.05）,两组间比较无统计学意义;D组最低,Ramsay评分C组最高,A组最低（p〈0.05）。结论0.2mg/kg地佐辛于手术结束前30min肌肉注射可安全有效减轻瑞芬太尼麻醉后痛觉过敏。

Effects of dezocine on postoperative hypergesia after remifentanil anesthesia

Objective To investigate the effect of dezocine on remifentanil-induced hyperalgesia postoperation.Method 80 cases of upper abdominal surgery, ASA Ⅰ～Ⅱ class, were randomly divided into four groups, using intravenous anesthesia plus intubation, intraoperative remifentanil target-controlled infusion, continuous intravenous injection of propofol and given intermittent vecuronium to maintain anesthesia. 0.1mg/kg （group A,n=20）,0.2mg/kg （group B,n=20）, 0.3mg/kg （group C,n=20） of dezocine were given intramuscular before 30min o f abdominal closure. Control group not given any agents （group D, n=20）. Records the time of recovery and extubation, hemodynamic parameters of extubation time, the VAS pain score and Ramsay score after extubation and the time of requirements of analgesia from extubation, adverse reactions with nausea and vomiting and dysthesia after extubation.Results There were no statistical significance of hemodynamic parameters of extubation （p〉0.05）; Group D has the longest awake and extubation time and the highest incidence of nausea and vomiting, Group A has the highest VAS score after recovery and group B and C has the lower（p〈0.05）, there were no statistical significance between group B and C; group D has the lowest VAS score.group C has the highest Ramsay score and group A has the lowest （p〈0.05）.Conclusion 0.2mg/kg of dezocine intrmuscular injection before 30min of the end of surgury can be safely and effectively reduce the hyperalgesia after remifentanil anesthesia.